NDLI: The placement of percutaneous retrograde acetabular posterior column screw based on imaging anatomical study of acetabular posterior column corridor

Content Provider	Springer Nature : BioMed Central
Author	Yu, Kequan Zhou, Runtao Gao, Shichang Liang, Anlin Yang, Mingming Yang, Haitao
Abstract	Objective To explore the entry point, orientation, and fixation range of retrograde acetabular posterior column screw. Method The computed tomography data of 100 normal adult pelvises (50 males and 50 females, respectively) were collected and pelvis three-dimensional (3D) reconstruction was performed by using Mimics software and the 3D model was imported into Geomagic Studio software. The perspective of acetabular posterior column was carried out orienting from ischial tuberosity to iliac fossa in the Mimics software. Virtual screw was inserted perpendicular to the transverse section of acetabular posterior column corridor, and the maximum screw diameter, entry point, orientation, exit point were measured. The screw fixation range, the easy-to-penetrate sites, and intraoperative optimal fluoroscopic views were assessed. Results The acetabular posterior column corridor showed a triangular-prism shape. The virtual screw entry point was located at the midline between the medial and lateral edges of the ischial tuberosity. The distance between the entry point and the distal ischial tuberosity was around 13 mm. The distances between the exit point and the true pelvis rim, and ipsilateral anterior sacroiliac joint line were (19.33 ± 2.60) mm and (23.65 ± 2.42) mm in males, respectively. As for females, those two data were (17.63 ± 2.00) mm and (24.94 ± 2.39) mm, respectively. The maximum diameters of screws were (17.21 ± 1.41) mm in males and (15.54 ± 1.51) mm in females. The angle between the retrograde posterior column screw and the sagittal plane was lateral inclination (10.52 ± 3.04)° in males, and that was lateral inclination (7.72 ± 2.99)° in females. Correspondingly, the angle between the screw and the coronal plane was anterior inclination (15.00 ± 4.92)° in males, and that was anterior inclination (12.94 ± 4.72)° in females. Retrograde acetabular posterior column screw through ischial tuberosity can fix the acetabular posterior column fractures which were not 4 cm above the femoral head center. The easy-to-penetrate sites were located at the transition between the posterior acetabular wall and the ischium, the middle of the acetabulum, and 1 cm below the greater sciatic notch, respectively. The iliac oblique 10°, iliac oblique 60°, and obturator oblique 60° views were the intraoperative optimal fluoroscopic views to assess whether the screw was safely inserted. Conclusion Retrograde acetabular posterior column screw entry point is located at the midline between the medial and lateral edges of the ischial tuberosity, which is 1.3 cm far from the distal ischial tuberosity. The screw direction is about 10° lateral inclination and 15° anterior inclination, which can fix the acetabular posterior column fractures which were not 4 cm above the femoral head center.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-022-03347-3.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-022-03347-3
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	17
Language	English
Publisher	BioMed Central
Publisher Date	2022-11-16
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Acetabular posterior column Retrograde screw Imaging anatomical study
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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